On March 29, UnitedHealthCare announced they were cutting the number of prior authorizations provided by 20% (see Easing The Prior Authorization Journey) over the course of the next year. Currently, UnitedHealthcare processes about 13 million prior authorization requests a year for about 600 million claims (see Dreaded Medical Paperwork Required By Health Insurers To Be Trimmed).

The UnitedHealthCare prior authorizations will be replaced by a national “gold card” program. Qualifying provider organizations will follow a "notification process" for most procedure codes rather than the prior authorization process (see UnitedHealthcare Cutting 20% Of Prior Authorizations). This program will apply to most . . .

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Health Care System

The United States health care system encompasses a mixture of private and public entities that are either non-profit or for-profit. Health care coverage may be financed through federal and state government programs or can be purchased through the health insurance marketplace. In contrast, a smaller proportion of the U.S. population is uninsured. The resulting effects of a decentralized system has led to considerable challenges for provider organizations—including cost pressures, a push towards alternative payment models, and market consolidation. Despite these challenges, there are opportunities for provider organizations in reducing excess costs and utilization, particularly as payers look for innovative approaches that can demonstrate a return-on-investment in terms of cost and consumer outcomes.


The North Carolina Department of Health and Human Services (NCDHHS) selected five organizations to serve as regional hub leads for the state’s Rural Health Transformation Program (RHTP). The selected organizations are Impact Health, Trillium Health Resources, Vaya Health, University of North Carolina Hospitals, and Access East. NCDHHS announced the selections on May 1, 2026, and expects to finalize the awards by June 1, 2026. The contracts are expected to run for five years. The organizations… Read